<!DOCTYPE HTML>
<html>
    <head>
        <title>Example</title>
        <meta name="author" content="Adam Freeman"/>
        <meta name="description" content="A simple example"/>
        <link rel="shortcut icon" href="favicon.ico" type="image/x-icon" />
    </head>
    <body>
        <form method="post" action="http://titan:8080/form">
            <fieldset>
                <legend>Enter Your Details</legend>
                <p><label for="name">Name: <input id="name" name="name"/></label></p>
                <p><label for="name">City: <input id="city" name="city"/></label></p>
            </fieldset>
            <fieldset disabled>
                <legend>Vote For Your Three Favorite Fruits</legend>
                <p><label for="fave1">#1: <input id="fave1" name="fave1"/></label></p>
                <p><label for="fave2">#2: <input id="fave2" name="fave2"/></label></p>
                <p><label for="fave3">#3: <input id="fave3" name="fave3"/></label></p>
            </fieldset>
            <button>Submit Vote</button>
        </form>
    </body>
</html>
